The House Finance Committee unanimously approved a bill to mandate insurance coverage for autism spectrum disorders (ASD), but the committee substitute differs significantly from the one that came out of interims and was sent to both chambers.
Committee members and bill supporters have mixed opinions of the new version of HB 2693.
As written, HB 2693 required coverage under PEIA and commercial insurance companies -- self-insured plans are exempted. It incorporated ASD treatment into the mental health statute and permitted coverage limits only if they complied with the federal Patient Protection and Affordable Care Act. Joint interim Judiciary Committee staff had said that other states have put ASD coverage in their mental health code, and it puts them on firmer footing looking ahead to federally mandated health care exchanges in 2014.
The committee substitute removes ASD from the mental health code and addresses it separately. It adds WVCHIP to the required coverage.
It also places monetary caps on Applied Behavior Analysis (ABA) -- the intensive, one-on-one therapy that is considered the only proven ASD treatment. The bill works under the assumption that children under 3 are covered under the federally subsidized Birth To Three program, which pays for some services for children with developmental delays.
There is pushback against mandates, with an assist from insurers.
The Sun Chronicle [Attleboro, MA] reports:
State Rep. Dan Winslow wants to strip away health insurance mandates to allow taxpayers to buy basic coverage in an attempt to drive down costs.
Winslow, R-Norfolk, said he has filed a bill called "Mandate Lite Health Insurance" that allows customers to buy just the coverage they want, rather than the full-blown policies the Legislature requires...
If customers were able to buy only the coverage they want without the mandates, the cost of policies would decline by 25 percent, Winslow said.
Also, basic policies without mandated coverage would weaken the concept behind pooling risks, he said.
However, Brian Rosman of Health Care for All said the Winslow idea has been proposed by others in the past and was found to be ineffective.
For one thing, he said, eliminating the mandated coverages would only save 3 percent to 4 percent, not the 25 percent Winslow cites, he said.
A customer who bought a basic policy would also be unable to afford coverage if he or she did come down with one of the conditions not covered by their policy, he said.
"The mandates are really there to prevent a race to the bottom by insurance companies," he said.
Winslow said he got the 25 percent savings figure directly from insurance companies.
Norman Leahy writes at The Washington Examiner:
The Virginia General Assembly is likely to approve a new mandate on health insurers to cover specialized treatment for autism. House Speaker Bill Howell, who supports the measure, believes it has been drawn narrowly enough that it won’t pose an undue burden on insurance premiums. Advocates say it will “…cost businesses less than $1 per month per autistic child…” Perhaps so. But it will still raise costs, something Virginia lawmakers have made quite a habit.
